A modern approach to the rehabilitation of patients with fractures of the bones of the lower extremities

BACKGROUND: General injury rates tend to increase in most federal districts of Russia. The patients with fractures of the bones of the lower extremities reaches for 8.5–25% of the total number of patients with fractures. Fractures of the bones of the lower extremities are characterized by long period of reparation, persistent contractures, a violation of the congruence of the articular surfaces, and changes in the biomechanics of walking. Only full course of rehabilitation can eliminate the these complications and restore the previous motor activity.

АIMS: The study aimed to analyze the structure of injuries in patients of the traumatology department and to present and the results of the recovery of patients with fractures of the bones of the lower extremities using and algorithm of organization of medical rehabilitation in the case study.

MATERIALS AND METHODS: A retrospective analysis of statistical data on 995 patients of the traumatology department № 1 of the Kazan City Clinical Hospital, who underwent 981 operations, was carried out. Randomly selected two groups of patients ― I main (n=45) and II control (n=45). Patients of group II after the treatment at the trauma center underwent outpatient medical rehabilitation, group I received inpatient medical rehabilitation in the rehabilitation department of the Kazan City Clinical Hospital № 7. In a hospital setting, a comprehensive rehabilitation program included physiotherapy exercises, CPM-veloergometry, exercises on rehabilitation simulators, the PNF kinesiotherapy technique, etc.

RESULTS: A more pronounced statistically significant positive dynamics at the end of the course of medical rehabilitation was noted in patients of group I (reduction of pain syndrome, increased joint mobility, degree of dependence on others, increased mobility index, the ability to dress independently, maintain body position in space, reduced dysfunction in lifting and carrying objects, walking disorders, and caring for body parts). The dynamics of motor function and psycho-emotional sphere also improved to a greater extent in patients of group I.

CONCLUSIONS: The effectiveness of the presented algorithm of organization of medical rehabilitation of patients with fractures of the bones of the lower extremities is confirmed by the results of present study. It is revealed that patients in the I (main) group showed more significant improvement in functions, activity and participation, a decrease of disability, reduce of pain, anxiety and depression, as well as an increase of the level of quality of life compared to patients of group II (control), who did not receive comprehensive medical rehabilitation in the hospital (p <0.1).